Dental Tips Blog


Dental Care for Patients With Rett Syndrome

Rett syndrome is a rare genetic disorder that primarily affects young females.  Most males with the disorder die during infancy.  Believed to be caused by a genetic mutation, Rett syndrome usually appears between the ages of 6 to 18 months.  Up to that point, the child develops normally, but then stops developing and begins to regress, losing fine motor skills and speech skills.

When the disease has fully developed, most individuals display repetitive hand and tongue movements, lack of motor control, and limited communication skills.  Most patients suffer from frequent seizures, shaking, abnormal breathing, and the inability to control their movements.

Dental care for patients with Rett syndrome can be very difficult.  Due to the patient’s inability to control their movements, frequent seizures, and breathing difficulties, traditional dental practices can be dangerous for these patients.

At the same time, it is very important for patients with Rett syndrome to maintain good oral health.  Most Rett syndrome patients, especially adolescents, have difficulty eating and accordingly do not get sufficient nutrition.  Poor oral health can make this problem even worse.

If you are a caregiver for a person with Rett syndrome, consider a consultation with a dentist who specializes in sleep and sedation dentistry.  Dentists who practice in this specialty area have advanced training in administering moderate to full sedation and treating dental patients under sedation.

Sleep and sedation dentistry is a humane, safe, painless way for many hard to treat patients to receive the dental care they need including everything from cleanings to filling cavities and other dental procedures.  In some cases, moderate conscious sedation is sufficient for the patient to comfortably tolerate the treatment in the dentist’s office.  For other, the safest and most comfortable option is full sedation in a specially equipped hospital operating suite.  Your dentist will determine an appropriate level of sedation depending on the needs of the patient.


Dental Care for Parkinson’s Patients

Parkinson’s disease is thought to be caused by low levels of dopamine in the brain and is characterized by tremors, slowness of movement, and rigidity. These symptoms tend to become more pronounced as the disease progresses.  The disease may be accompanied by other symptoms such as dementia and anxiety.  Some Parkinson’s patients may have swallowing difficulties.

Good dental care can be a challenge for Parkinson’s patients.  The inability to control movement makes traditional dental care in a dentist’s office difficult or even dangerous.  Getting regular dental care for Parkinson’s patients is important for the patient’s oral and overall health.  Due to poor motor control, many patients have difficulty brushing their teeth properly.  Without regular professional dental care, oral heath can rapidly deteriorate

Poor oral health has been linked to heart disease.  In addition, Parkinson’s patients require a diet with higher than normal caloric intake, but dental issues can cause the patient to eat less or to consume foods that have low nutritional values.

For home dental care, many patients find that using an electric toothbrush is an effective technique.  The electric toothbrush has greatly improved the oral hygiene of many Parkinson’s patients.

Getting effective routine dental care depends on the extent of the disease.  In the early stages of the disease, strategic timing of the patient’s visits to the dentist to coincide with the most effective periods of the patient’s medication can be enough for the patient to tolerate traditional dentistry.

As the disease progresses, dental procedures may be more safely and comfortably completed with the patient partially or fully sedated.  There is a small group of dentists who specialize in sleep and sedation dentistry.  These dentists are better equipped and experienced treating special needs patients.


Anxiety and Pain Control at the Dentist

Your dentist has a range of options when it comes to minimizing the pain, discomfort, and anxiety that may be present in a visit to the dentist.  An understanding of the options can help you have a productive discussion with your dental care provider.

Local anesthesia such as Novocain has long been the primary means of numbing the area of the patient’s mouth where the dental work is to be accomplished.  For many patients, local anesthesia is adequate to provide a comfortable dental experience.

For those patients who need more than a local anesthetic, your dentist can choose from a range of sedation levels.  While anesthesia refers to the elimination or reduction of pain, sedation is a depressed level of consciousness ranging from minimal sedation to fully unconscious sedation.  Sedation also has a pain reduction component in addition to the depression of consciousness and it reduces or eliminates anxiety.

Sedation is a continuum from minimal sedation to full sedation, but it can be broken up into rough categories. Minimal sedation is usually achieved through the use of oral medication taken before the appointment or the use of nitrous oxide.  The patient is conscious and can easily respond to questions.

Moderate sedation is achieved using oral sedatives or mild intravenous sedative.  The patient is very drowsy and can answer questions, but may fall asleep during the procedure.

Deep sedation is usually achieved through the administration of intravenous sedatives.  The patient can be awoken with some effort and may have difficulty responding to questions.

The deepest level of sedation is unconscious sedation under general anesthesia.  The patient is unconscious and cannot be awoken to answer questions.

Not all dentists use the full range of available sedation.  Most dentists are qualified to use minimal to moderate sedation, but only dentists with advanced training in sleep and sedation dentistry can offer deep sedation and general anesthesia.  Talk to your dentist about the level of sedation that is right for you.


Candidates for Hospital Sleep Dentistry

Sleep and sedation dentistry refers to a broad category of sedation alternatives used by dentists to relax patients and minimize discomfort and pain.  Arguably it includes everything from nitrous oxide (laughing gas), oral sedatives, and intravenous sedatives to full unconscious sedation under general anesthesia.  Each level of sedation best fits the needs of certain types of dental patients with some overlap depending on the needs of the patient and the dental procedures to be performed.

The deepest level of sedation used in dentistry is full unconscious sedation under general anesthesia.  A qualified anesthesiologist sedates and monitors the patient while the dentist performs the dental procedures.  Even though an anesthesiologist is involved, the dentist needs advanced training to perform dentistry under general anesthesia.  Most sleep and sedation dentists use a hospital operating room specially equipped for dentistry to treat dental patients under general anesthesia.

Generally speaking, your dentist will use the lowest level of sedation that will allow the procedure to be safely performed while providing the patient with a comfortable dental experience.  The dentist and patient will determine if general anesthesia is a good option, but possible candidates include patients who have severe dental anxiety, uncontrollable gag reflex, or physical, developmental, or medical conditions that make general anesthesia a better option than more moderate conscious sedation.

General anesthesia can also be a good alternative for patients that need extensive dental work.  The patient can have all of the work done in one or two procedures instead of having to return to the dentist’s office repeatedly over the course of weeks or months.  The patient only has a single recovery period and only has to take one or two days off from work.


Huntington’s Disease and Dental Care

Huntington’s disease is an inherited disorder that typically strikes when the patient is in their 40’s or 50’s.  It causes nerve cells in the brain to degenerate, resulting in movement disorders such as involuntary jerking, muscle contractions, and difficulty swallowing.  Patients also often lack the ability to control their impulses and may suffer from mania, anxiety, and obsessive-compulsive behavior.

Good dental care is important for individuals with Huntington’s disease.  Due to the difficulty in swallowing, patients have a difficult time eating enough and often turn to a diet high in sugar to get the calories they need.  At the same time, they often lack the physical dexterity to brush their teeth properly.  The combination of a high sugar diet and poor brushing habits results in poor oral health and a higher than normal rate of developing cavities.

Regular routine dental care including frequent cleanings can help, but normal dental practices can be dangerous for Huntington’s disease patients because of their inability o control their movements.  If you are a caregiver for a person with Huntington’s disease, talk to your dentist about increased focus on the prevention of tooth decay in the patient.  More frequent cleanings and the application of fluoride can help slow tooth decay.

In addition, look for a dentist that specializes in sleep and sedation dentistry.  Only a few dentists have the training and experience needed for this specialty practice area, but sleep and sedation dentistry is a humane way for Huntington’s disease patients to get high quality dental care safely, comfortably, and without pain or anxiety.

The dentist will recommend a level of sedation appropriate for the individual patient and the dental procedures needed.  The sedation can range from moderate conscious sedation to full general anesthesia.  Sleep and sedation dentistry has helped millions of special needs patients get the dental care they need.


Dental Care for Patients with Dental Anxiety

If you get anxious, start sweating, and your heart starts racing when you think about going to the dentist, you are not alone.  Millions of Americans suffer from moderate to severe dental anxiety.  You may be so terrified of going to the dentist that you never even consider it, or it may be the sound of the drill or the sight of a needle that causes your anxiety.  Whatever level of dental anxiety you feel, you are in good company.

If your dental anxiety is keeping you from getting routine dental care, or if you want a dental experience with lower levels of stress, consider making an appointment for a consultation with a sleep and sedation dentist.

In addition to the standard anesthetics such as novocain and nitrous oxide, sleep and sedation dentists have specialized training in administering intravenous sedatives and delivering dental care to patients who are partially or fully sedated.  Intravenous sedatives are usually administered in the dentist’s office and are carefully controlled to put the patient in a dreamy, sleep like state.  Novocain is usually also used to numb the area, but it is administered after the patient is sedated to make the entire experience as painless and comfortable as possible.

Full sedation with general anesthesia is administered in a hospital operating room by a qualified anesthesiologist.  The sleep and sedation dentist performs the dental procedures while the anesthesiologist monitors the patient.  For both partial and full sedation, the patient almost always has no memory of having the procedure.

Dental anxiety should not prevent you from getting the dental care you need.  Sleep and sedation dentistry is the safe, painless, and comfortable solution to dental anxiety.


Sedation Dentistry for Extensive Dental Work

Most Americans don’t exactly look forward to the next trip to the dentist, even just for routine cleanings, but except for those who suffer from moderate to severe dental anxiety, most patients tolerate a single dental procedure reasonably comfortably and go home with the satisfaction that it will be awhile before they need to sit in the dental chair again.

However, some patients need extensive dental work that cannot be comfortably completed in one dental appointment.  Maybe they put off their dental work a little too long, or their dental issues all appeared at about the same time, or the procedure is simply very complex and will take a long time for the dentist to complete the work.

Whatever the reason, these patients need two or more dental appointments for all of the necessary work to be performed.  That means going through the whole process two, three or more times:  taking time off work, sitting in the waiting room, getting injected with novocaine, enduring the procedure, and waiting for the novocaine to wear off.

Sedation dentistry offers a better alternative for dental patients who need extensive work.  Dentists who practice sleep and sedation dentistry use various levels of sedation to allow a patient to have all of their dental work completed in a single appointment.  Depending on the procedure and the needs of the patient, the dentist may put the patient into a mild, sleepy state or into a deeper, full sedation under general anesthesia.

With sedation dentistry, the patient does not have to make multiple trips to the dentist.  All of the work is done in one procedure.  The patient avoids the repeated dental visits and only has one recovery period.  Sedation dentistry is safe and comfortable.  In most cases, the patient sleeps through the procedure and has no memory of it when they awaken.

If you need extensive dental work, consult with a dentist who specializes in sleep and sedation dentistry.


Dental Care and Heart Problems

People with severe heart conditions should take extra precautions when getting dental care.  Patients with cardiac conditions such as congestive heart failure, high blood pressure, angina, and other heart problems have to be careful to  avoid unnecessary stress that can increase their blood pressure and aggravate existing heart conditions.

Unfortunately, many heart patients suffer from dental anxiety ranging from mild to severe.  Some heart patients avoid dental care altogether because they are concerned about the added stress that the dental procedure will cause.

An effective and safe alternative for heart patients is sleep and sedation dentistry.  Only a few dentists have the specialized training necessary to practice sleep and sedation dentistry.   They perform dental procedures on patients who are moderately or fully sedated.  The result is a low stress, painless and comfortable dental experience.

A sleep and sedation dentists will determine the appropriate level of sedation for each patient.  Some patients will be given intravenous anesthetics to place them in a drowsy, sleep-like state.  The patient is conscious and can answer questions, but they are so relaxed and comfortable that most patients will doze through the procedure and have no memory of it afterward.

For patients who need a deeper level of sedation, the dental procedures will be performed in a hospital operating room.  A qualified anesthesiologist will administer general anesthesia and monitor the patient while the dentist completes the work.

For patients with heart problems, sedation dentistry is a stress-free, comfortable option for receiving dental care.  Since there is such low stress, sleep and sedation dentistry is the safer alternative for heart patients who need to keep their blood pressure under control.


Dental Care When Novocain Does Not Work

For the majority of dental patients, novocain or a similar local anesthetic is used to numb the area of the mouth where the dental work is to be performed.  Most patients will feel very little pain or discomfort when they are numbed with novocain.  However, a small percentage of the population does not respond to local anesthetics and cannot get numb.

If you are one of these patients who cannot get numb, sleep and sedation dentistry may be the answer.  Not all dentists practice sleep and sedation dentistry.  In fact, only a select few dentists have the training and experience to practice sleep and sedation dentistry.  Most dentists use a local anesthetic such as novacain along with nitrous oxide or oral sedatives.  Dentists trained in sleep and sedation dentistry use all of these anesthetics and sedatives, but in addition they use intravenous sedatives or general anesthesia, depending on the needs of the patient.

Patients who do not get numb with novocain can receive excellent dental care while under general anesthesia or when moderately sedated using intravenous sedative.  IV sedatives are more effective at eliminating pain, discomfort and anxiety than oral sedatives because the amount of sedative can be regulated to keep the patient comfortable.

Whether the dentist uses intravenous sedatives or general anesthesia, the patient feels no pain or discomfort and usually does not remember the dental procedure.  Sleep and sedation dentistry is a safe, effective way for patients who do not get numb with novocain to get the dental care they need.  Ask your dentist about sleep and sedation dentistry.  If your dentist does not practice sleep and sedation dentistry, they may be able to refer you to a sleep and sedation dentist.


Pediatric Sleep and Sedation Dentistry

Sleep and sedation dentistry is an excellent alternative for patients who are difficult to treat in a traditional dental office setting or who cannot tolerate traditional dental care.  Candidates for sleep and sedation dentistry include patients with moderate to severe anxiety, patients with a severe gag reflex, developmentally or physically disabled patients, and patients who are allergic to or do not respond to novocaine.

In addition, sleep and sedation dentistry is a wonderful alternative for small children who are unable to hold still throughout a dental procedure or who might become uncooperative.  Instead of causing the child unnecessary stress and anxiety, sleep and sedation dentistry allows them to have a pleasant dental care experience with no pain or discomfort.

A small but growing group of experienced dentists have received the necessary training to provide sleep and sedation services.  If your dentist does not offer this service, they may be able refer you to a dentist who does.  In sleep and sedation dentistry, the patient is partially or fully sedated deeper than achieved with nitrous oxide (laughing gas).  The dentist determines the level of sedation necessary which can range from a moderate drowsy sleep like state to full unconscious sedation under general anesthesia.

Full sedation is usually performed in a hospital surgical suite with the assistance of an anesthesiologist and surgical nurses.  Milder forms of sedation can be handled either in the hospital or in the dentist’s office, depending on the needs of the patient.

Sedation dentistry is the safe, comfortable way for small children to receive high quality dental care.  The work can be finished in a shorter period of time and the child will be comfortable and relaxed throughout the procedure.

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